【摘要】 目的 通过分析胸痹心痛患者的临床资料，探讨不同中医证型与冠状动脉造影术血管病变相关指标的联系，为中医证型客观化诊疗及中西医结合防治胸痹心痛提供一定参考。方法 以2024年度固镇县中医院内科收治的621例经冠状动脉造影确诊的胸痹心痛患者为研究对象。通过采集患者年龄、性别、住院天数及冠脉造影数据(狭窄程度、优势侧分布、病变支数),使用Gensini评分量化冠脉病变严重程度。重点探讨胸痹心痛患者中医证候分布特征及冠脉造影显示的血管病变程度、解剖特征(病变支数、优势侧)等客观指标与中医证型间的相关性。结果 621例胸痹心痛患者性别构成男女比例约1.06∶1,以中老年群体居多。性别与中医证型差异无统计学意义(P>0.05),住院时长与中医证型存在显著关联(P<0.05)。中医证型分布心血瘀阻型居首位，痰浊内阻型次之。冠状动脉优势型以右优势型为主，各优势型中均以心血瘀阻型为主，中医证型与优势型差异无统计学意义(P>0.05)。中医证型与血管狭窄程度有统计学意义(P<0.05),各证型以重度狭窄为主，其中血瘀、痰浊证型最为突出。血管受累支数分布具有证型差异(P<0.05),其中多支病变中血瘀、痰浊明显高于其他证型。Gensini评分显示不同证型间存在显著差异(P<0.05)。结论 胸痹心痛患者以中老年人群为主，中医证型分布呈线梯度特征，与病变支数、狭窄程度及Gensini积分显著相关。其中心血瘀阻型、痰浊内阻型为胸痹心痛核心证型。该研究传统与现代诊疗技术相结合，为胸痹心痛患者中医临床诊疗提供客观、准确的依据。更多还原

【Abstract】 Objective By analyzing the clinical data of patients suffering from chest obstruction and heart pain, this study discusses the relationships between different Traditional Chinese Medicine syndromes and indicators related to vascular lesions observed in coronary angiography, providing a reference for the objective diagnosis and treatment of TCM syndromes, as well as for the combined prevention and treatment of chest obstruction and heart pain using integrative approaches from both Western and Chinese medicine.Methods This study examines 621 patients diagnosed with chest pain through coronary angiography who were admitted to the Department of Internal Medicine at Guzhen County Traditional Chinese Medicine Hospital in 2024.Data collected include patient age, gender, length of hospital stay, and results from coronary angiography(degree of stenosis, distribution of dominant side, and number of lesions).The Gensini score was employed to quantify the severity of coronary artery disease.The primary focus of the study is to investigate the correlation between the distribution characteristics of Traditional Chinese Medicine syndromes in patients with chest pain and objective indicators of vascular lesions and anatomical features(number of lesions, dominant side) as shown by coronary angiography.Results In a study of 621 patients with chest obstruction and heart pain, the gender ratio was approximately 1.06∶1,predominantly consisting of middle-aged and elderly individuals.There was no statistically significant difference between gender and traditional Chinese medicine(TCM) syndromes(P>0.05),while the length of hospital stay exhibited a significant correlation with TCM syndromes(P<0.05).The distribution of TCM syndromes showed that ‘blood stasis obstruction’ was the most common, followed by ‘phlegm-damp obstruction.’ The dominant type of coronary artery was primarily right-dominant, and ‘blood stasis obstruction’ was predominant in all dominance types, with no statistically significant difference between TCM syndromes and dominance types(P>0.05).A significant correlation was found between TCM syndromes and the degree of vascular stenosis(P<0.05),with severe stenosis being the most prevalent across all syndromes, particularly notable in ‘blood stasis’ and ‘phlegm-damp’ syndromes.The distribution of affected vascular branches differed based on the syndrome(P<0.05),with a significantly higher prevalence of ‘blood stasis’ and ‘phlegm-damp’ in multiple vessel lesions.Gensini scores indicated significant differences between various syndromes(P<0.05).Conclusion Patients with chest tightness and heart pain are predominantly from the middle-aged and elderly population.The distribution of traditional Chinese medicine syndromes exhibits a gradient characteristic, which is significantly correlated with the number of lesions, degree of stenosis, and Gensini score.Among these, the core syndromes of chest tightness and heart pain are the blood stasis obstruction type and the phlegm-dampness obstruction type.This study combines traditional and modern diagnostic and therapeutic techniques, providing an objective and accurate basis for the clinical diagnosis and treatment of coronary heart disease patients in traditional Chinese medicine.更多还原